CIRCADIAN INTERVENTIONS FOR THE RECENTLY RECENTLY BEREAVED ELDERLY

该项目的目的是测试一种旨在帮助寡妇和鳏夫过上健康、正常生活的干预措施。具体地说，它旨在保护最近失去亲人的老年人免受睡眠中断的影响，以及由此造成的健康、情绪、警觉性和白天功能的损害。这种干预旨在培养受试者日常生活中高度的规律性，从而增强她/他的昼夜节律的幅度和相位稳定性，并鼓励健康的睡眠习惯。将与年龄和年龄进行比较 性别匹配的对照组，将接受情绪集中治疗(EFT)，作为心理治疗的安慰剂。60名老年(65岁)受试者(包括男女)，目前没有使用抗抑郁药物，将在配偶丧亲后3个月内被招募。一半人将被随机分配到社会节奏疗法(SRT)干预(其中也将包括健康睡眠实践的教育)，另一半人将被分配到EFT控制条件下。SRT组将参加10个社交节律治疗课程(分6个月进行)。在那里，治疗师将 讨论受试者每天记的每周日记，鼓励受试者在睡觉时间、用餐时间、社交等日常活动中保持高度的规律性，并教育受试者健康的睡眠行为和理论。对照组将参加10次EFT课程。将有4个评估点：T1(基线)、T2(3个月。进入治疗)、T3(治疗结束时(6个月)、T4(治疗后12个月)。将对T1和T3的睡眠、昼夜节律、情绪、警觉性和表现进行36小时的实验室评估。这将是 包括连续36小时的核心体温测量，2个晚上的多导睡眠图(PSG)，MSLT警觉性评估，以及一系列情绪、警觉性和表现测量。在每次实验室评估之前，在T2和T4，将进行为期两周的实地评估，包括完成社会节律指标(SRM)，以及完成为期两周的匹兹堡睡眠日记(PghSD)、一周的活动记录、一组绩效评估以及心理和身体健康、情绪、警觉性和幸福感的测量。主 有待检验的假设是，老年寡妇(呃)S的健康、机能、警觉性幸福感和表现水平受到睡眠质量和持续时间的调节，而改善可以通过增加生活方式的规律性和健康的睡眠习惯教育来实现。还将使用其他组成部分项目数据进行计划范围的分析，以便在相当大的老年人群体中评估日常生活方式规律性(SRM得分)作为睡眠、健康和幸福感之间联系的中介变量。

The aim of this Project is to test an intervention designed to help widows and widowers lead healthy well-functioning lives. Specifically, it seeks to protect recently bereaved elders from sleep disruptions and from resulting impairments in health, mood, alertness and daytime functioning. The intervention is designed to develop high levels of regularity in the subject's routine, and thus to enhance the amplitude and phase stability of her/his circadian rhythms, as well as encouraging healthy sleep practices. Comparisons will be made with an age and gender matched control group who will receive Emotion-Focused Therapy (EFT), which acts as a psychotherapy placebo. Sixty elderly (65y+) subjects (both genders), not currently using anti-depressants, will be recruited within 3 months of spousal bereavement. Half will be randomly assigned to the Social Rhythm Therapy (SRT) intervention (which will also include education in healthy sleep practices), and half to the EFT control condition. The SRT group will attend ten social rhythm therapy sessions (spread over 6 mos.) at which a therapist will discuss a weekly diary kept by the subject every day, encouraging a high level of regularity in daily events such as bedtimes, meals, social contacts, etc., as well as educating the subject in healthy sleep behaviors and theory. The control group will attend ten EFT sessions. There will be 4 evaluation points: T1 (baseline), T2 (3 mos. into treatment), T3 (at completion of treatment (6 mos.), T4 (12 month post-treatment follow-up). There will be a 36h laboratory evaluation of sleep, circadian rhythms, mood, alertness and performance at T1 and T3. This will involve 36h of continuous core body temperature measurement, 2 nights of polysomnography (PSG), an MSLT assessment of alertness, and a battery of mood, alertness and performance measures. Prior to each laboratory evaluation, and at T2 and T4, there will be a two-week field evaluation involving completion of the Social Rhythm Metric (SRM), as well as completion of a two-week Pittsburgh Sleep Diary (PghSD), one week of actigraphy, a performance battery and measures of mental and physical health, mood, alertness and well-being. The main hypothesis to be tested is that health, functioning, alertness well-being and performance levels in elderly widow(er)s are mediated by the quality and duration of their sleep, and that improvements can be wrought by a therapy involving increased lifestyle regularity and healthy sleep practices education. Program-wide analyses using other component project data will also be undertaken in order to evaluate daily lifestyle regularity (SRM score) as a mediating vadable in the link between sleep, health and well-being, in a fairly large group of seniors.